Related Experiment Video

Updated: Sep 16, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

493

Obstructive Hypertrophic Cardiomyopathy and Aortic Stenosis With High Surgical Risk

Omar M Abdelfattah1, Robyn Bryde2, Kutaiba Nazif3

  • 1Center for Hypertrophic Cardiomyopathy and Sports Cardiology, Gagnon Cardiovascular Institute, Department of Cardiovascular Medicine, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA.

JACC. Case Reports
|July 4, 2025
PubMed

Insights

Treating aortic valve stenosis (AS) with hypertrophic cardiomyopathy (HCM) is difficult. Alcohol septal ablation (ASA) and mavacamten can improve AS assessment and reduce transcatheter aortic valve replacement (TAVR) complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Imaging

Background:

  • Accurate assessment and treatment of severe aortic valve stenosis (AS) in patients with obstructive hypertrophic cardiomyopathy (HCM) present significant clinical challenges.
  • The combined pathology necessitates careful consideration of therapeutic strategies to optimize patient outcomes.

Observation:

  • A case series of 6 patients with obstructive HCM and severe AS undergoing alcohol septal ablation (ASA) was analyzed.
  • Follow-up reassessment revealed a downgrade in AS severity in 3 patients post-ASA.
  • One patient required mavacamten for residual obstruction prior to transcatheter aortic valve replacement (TAVR); TAVR was completed in 2 patients.

Findings:

  • Alcohol septal ablation (ASA) can effectively reduce left ventricular outflow tract obstruction in obstructive hypertrophic cardiomyopathy (HCM).
  • Post-intervention, Doppler assessment of aortic valve stenosis (AS) severity becomes more accurate, potentially altering management decisions.
  • Staged interventions involving ASA and/or mavacamten prior to TAVR are feasible and beneficial.

Implications:

  • A staged approach utilizing ASA and/or mavacamten before TAVR offers a strategy to improve AS assessment and procedural safety.
  • This approach may mitigate complications associated with TAVR in the setting of obstructive HCM.
  • Further research into the combined use of mavacamten and TAVR is warranted given limited current data.
Abstract

Keywords:
TAVRalcohol septal ablationaortic stenosishypertrophic cardiomyopathymavacamtentranscatheter aortic valve replacement

More Related Videos

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

11.8K
O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy09:24

O-Ring Aortic Banding Versus Traditional Transverse Aortic Constriction for Modeling Pressure Overload-Induced Cardiac Hypertrophy

Published on: October 6, 2022

3.7K

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
51
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
28
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
45
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
61
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
29
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
38